TY - DATA T1 - High first-trimester maternal blood cystatin C levels despite normal serum creatinine predict pre-eclampsia in singleton pregnancies PY - 2017/10/26 AU - Martin Risch AU - Mette-Triin Purde AU - Marc Baumann AU - Markus Mohaupt AU - Beatrice Mosimann AU - Harald Renz AU - Luigi Raio AU - Daniel Surbek AU - Lorenz Risch UR - https://tandf.figshare.com/articles/journal_contribution/High_first-trimester_maternal_blood_cystatin_C_levels_despite_normal_serum_creatinine_predict_pre-eclampsia_in_singleton_pregnancies/5539621 DO - 10.6084/m9.figshare.5539621 L4 - https://ndownloader.figshare.com/files/9591214 KW - Beta-trace protein KW - beta-2-microglobulin KW - creatinine KW - cystatin C KW - glomerular filtration rate KW - placental growth factor KW - pre-eclampsia KW - reference intervals KW - uric acid KW - uromodulin N2 - Early biochemical identification of women at high risk for the development of pre-eclampsia (PE) is still unsatisfactory. Renal markers measured during the first trimester were analysed to predict later occurrence of PE. A nested case-control study was conducted within the prospective predictive markers for the diagnosis of preeclampsia study. Pregnant women were included at the end of the first trimester and followed up until birth. Controls were matched to PE cases. Renal markers [i.e. creatinine, cystatin C (CysC), β2 microglobulin (B2M), β-trace protein (BTP), glomerular filtration rate estimations (eGFR) of the aforementioned markers, uric acid (UA), urea, and serum uromodulin (sUMOD)] were compared to placental growth factor (PlGF), a marker known to predict PE later in pregnancy. Reference intervals were determined for the different markers. In the 183 women (PE, n = 39; controls, n = 144), CysC, the CysC/PlGF ratio (p < .01) and UA were higher, whereas the eGFRCysC/eGFRCrea ratio (a marker of glomerular endothelial integrity and shrunken pore syndrome) and PlGF were lower in women who developed PE (p < .05 for all). Compromised filtration of the larger molecule CysC together with a normal creatinine, in a subset of PE cases (15.3%) was a unique, strong and independent predictor of later PE if the baseline CysC concentration was >0.85 mg/l. In conclusion, CysC and its derivatives as well as UA, indicating volume expansion, measured at the end of the first trimester are predictive of PE. Thus, women can be easily identified and followed as an early reduction in glomerular filtration quality poses a high risk for a subsequent development of PE. ER -